Basal dose short at moment....

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Amity Island

Amity Island

Well-Known Member
Relationship to Diabetes
Type 1
Hi Everyone,

I'm really appreciating all the help from the members on here since I joined a few days ago.

I just started Tresiba a week go, so my basal dose is currently short at the moment, i'm having to add an extra 4u of humalog every 6hrs to keep blood sugars safe. Does anybody know how you can work out from how much extra short acting/bolus you are taking through the day, how this equates to how short your basal must be? I'm taking 16u of extra short acting through a day, is it as simple as being 16u short on the basal?
 
I would ring your team and ask them x
 
Taking extra bolus during the day can't really equate to an overall basal total, because your body's needs during the night may vary; testing and adjusting is the only way, in my opinion, to sort out your basal. Have your team left you to get on with it, or are they expecting you to report back to them for advice on dose adjustment? Either way, I think Kaylz is right, you need to give them a call, tell them your levels aren't right, and ask for their help.
 
Amity Island said:
They don't like me ringing and they won't see me either. Don't know what's going on. Said I'll see you in 4 months.
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Hi. Sorry to hear this, sounds like poor you have a poor care team.
Personally I think that you need to be that squeaky wheel you know the one, the one that gets the most oil. You obviously need /want experienced professional advise and not to be able to access it is awful.

Sounds like doing a basal test would be a good idea.
You'll find info on basal testing here.
http://www.diabetes-support.org.uk/info/?page_id=120
 
Amity Island said:
'm taking 16u of extra short acting through a day, is it as simple as being 16u short on the basal?
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I can't give you advice, as I am just some random nutter on the internet. But I can share my experience which is that for me it is absolutely NOT the case that diabetes works out like that maths-wise. If my basal is slightly short I can need to add units and units of insulin in corrections, but when I finally basal test and cautiously adjust my background dose I need to add a very small amount spread over the day.

In your shoes I would first do a fasting basal test to ensure that it actually WAS my basal that was adrift. And then adjust by something like 10% of my dose if it seemed an adjustment was necessary. Leave that a couple of days... recheck... repeat... and so on.

There's a helpful guide to basal testing here http://www.diabetes-support.org.uk/info/?page_id=120.

As others have said you do need to be cautious especially with a flat-ish profile insulin like Tresiba, because your requirements through the day might be varied. And you risk your basal over-reaching your needs of you push it up too high, which will more than likely give you a ton of hypos.

Good luck with it!
 
Ljc said:
Hi. Sorry to hear this, sounds like poor you have a poor care team.
Personally I think that you need to be that squeaky wheel you know the one, the one that gets the most oil. You obviously need /want experienced professional advise and not to be able to access it is awful.

Sounds like doing a basal test would be a good idea.
You'll find info on basal testing here.
http://www.diabetes-support.org.uk/info/?page_id=120
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Told me they don't see patients.
 
Amity Island said:
Told me they don't see patients.
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Just ???????????

How the hell can they be your 'team' if they don't see their patients? Can you not get your care transferred to a different hospital?
 
Ljc said:
That's dreadful , I assume this is a hospital diabetic team ?
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Not hospital, operate from a walk in centre. Think they have a diabetes consultant and a couple of nurses there.
Robin said:
Taking extra bolus during the day can't really equate to an overall basal total, because your body's needs during the night may vary; testing and adjusting is the only way, in my opinion, to sort out your basal. Have your team left you to get on with it, or are they expecting you to report back to them for advice on dose adjustment? Either way, I think Kaylz is right, you need to give them a call, tell them your levels aren't right, and ask for their help.
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Hi, that's part of the problem, cos I'm on tresiba, any adjustments take days to take effect.
 
I sill don't understand WHY they changed you to it.
 
trophywench said:
Just ???????????

How the hell can they be your 'team' if they don't see their patients? Can you not get your care transferred to a different hospital?
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I did ask my G.P, but he thinks you can only go to your local area one, I have however been advised since that this is not the case, patients have a choice where they want to go.
 
I would give the Diabetes UK helpline a ring. I believe there are number of members who don't go to thier local hospital clinic they go to one another hey want.
 
Agree with Jenny, not sure why you were changed. If you're not happy with it, tell them. I'd been on Levemir for over 10 years. Had one serious hypo last year (my awareness has all but disappeared) resulting in a car accident and happened to see a new consultant a few days later who suggested Tresiba. I was still shaken up from the accident and agreed to it. After a few months it was clear to me that due to the exercise I do it wasn't working well enough for me. It was okay and I could live with it and had lived with it including carrying on exercising but the split Levemir was a better more flexible option. I spoke to my DSN on the phone and explained all this, she agreed and changed the prescription with the GP back to Levemir. All relatively straightforward.
 
Exactly @Matt Cycle - they are intended to be there to HELP us - not damnwell DICTATE what we can and can't do !
 
Amity Island said:
Told me they don't see patients.
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Amity Island said:
Hi Kaylz, I would ring them but they don't like to be called and they don't normally see patients I've been told.
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Err... What DO they do then?? They can't just change your medication and then expect you to disappear for several months without checking whether it's working or answering any concerns you may have! That's appalling - please try to change to a different team!
 
Sally71 said:
Err... What DO they do then?? They can't just change your medication and then expect you to disappear for several months without checking whether it's working or answering any concerns you may have! That's appalling - please try to change to a different team!
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I know, I have spoken to my g.p, he's writing a letter to them to try and get them to help me, to actually see me. Honestly, because i've never needed any help before, I never knew type1 diabetes care was so bad, it's really been very distressing. I think there may be deep routed issues there, like low moral, jaded, hate their jobs etc.
 
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